OK, the dilated vessels are not necessarily part of the inflammatory process. These enlarged vessels are referred to as esophageal varices and result from increased blood flow. The increase in blood flow results from increased hepatic portal resistance and the subsequent development of hepatic portal hypertension (increased hepatic portal blood pressure). This resulting increased portal blood pressure leads to a greater flow of blood returning to the systemic venous circulation by way of the anastomosing vessels in the lower third of the esophagus as well as those in the rectum. This change in the vascularity of the liver is a permanent alteration associated with cirrhosis. Cirrhosis results from the liver's attempts to heal itself in the face of chronic and on going injury. The result is one of scaring and "botched" nodular regeneration of the liver lobules. This deranged vascular flow in the liver is one of the most significant outcomes of cirrhosis.
 

Mark Braun, MD braunm@indiana.edu
Copyright 1998, the Trustees of Indiana University